Types and Causes of Reflux in Newborns

Newborn baby being bottle fed
Bottle feeding can increase reflux in newborns

Reflux in newborns is a semi-common issue among babies. There are various types of reflux, and most of these types are not normally a huge problem.

Types of Newborn Reflux

Some of the different types of reflux include the following:

  • Gastro Esophageal Reflux, (reflux or GER): Some studies show that almost two thirds of newborn babies are reported as having GER, although it tends to peak around four months and totally resolve by 12 months.
  • Gastroesophageal Reflux Disease (GERD): This is not as common, with only 1 in about 300 babies presenting symptoms. GERD is more serious than GER though and often presents in babies with neurological impairments.
  • Silent GERD or GER: Silent reflux is pretty much what you might think--reflux that shows no typical symptoms.
  • Laryngopharyngeal reflux: This is just a term for reflux that reaches the upper esophageal sphincter and the back of a baby's throat.
  • Secondary GER: This is when GER is not occurring on its own due to typical reasons, but is, in fact, caused by something else such as a food allergy or infection.

Causes of Newborn Reflux

While symptoms and types of reflux in newborns vary, all cases have the same sort of cause or physiological events that occur.

Basically, reflux is when a muscle at the stomach opening opens at the wrong time. When this opening opens at incorrect times, then milk can back up into a baby's esophagus. The problem is that mixed with the milk now (after your baby drinks) are gastric juices that are really acidic. When something acidic comes back up, it can irritate, burn, and cause pain to the throat and esophagus. You can see a diagram of this process at the Mayo Clinic website.

Symptoms of Newborn Reflux

Basic reflux in newborns, or GER, is a normal situation that most people (of any age) experience occasionally. This is that backward flow of gastric juices described above. It usually causes a baby to spit up. This can occur in breastfed or formula fed babies and is not too big a problem. If a baby has plain old GER, he won't show any other unusual symptoms. Unusual gastrological symptoms might include weight loss, extreme agitation, or respiratory problems. Basic GER does not equal a sick baby. Babies with GER thrive, seem content as usual, and are common.

Babies with GERD are another story. Less common and more serious than GER, babies with this usually do show extra symptoms that can make their life difficult. Some symptoms include poor growth or failure to thrive, a dislike of eating, wheezing, bad cold-like symptoms, and persistent spitting up.

Laryngopharyngeal Reflux is also more serious than GER, causing sore throat pain, chronic cough, and odd sounds, such as a nasal-like cry or hoarseness.

With silent GER, a baby will not show symptoms because he's possibly bringing up gastric acids and then swallowing them back down. Obviously if the spit up doesn't show, it is difficult to diagnose GER. However, a baby with silent GER may act super cranky, have feeding aversions, or cry more after meals than at other times. There are many more symptoms of silent GER as well. If you think your baby may have silent GER, you should make an appointment with your pediatrician.

Prevention of Reflux in Newborns

Reflux, as noted above, is something all people may experience from time to time, so you can't likely stop every single episode of reflux your baby will have. However, you can do some things that can help prevent reflux from occurring as often.

  • Breastfeed: One of the major breastfeeding benefits is a reduced risk of serious reflux. Almost all studies surrounding baby reflux show that breastfed babies experience far less instances of reflux than formula fed babies. Also, when they do experience reflux, the symptoms are less severe. Most researchers think that this is a combination of the health benefits of breast milk and the fact that babies who breastfeed tend to take in less air than bottle fed babies.
  • Feed small meals: If you break up mealtime into smaller, more frequent meals, rather than feeding baby larger and infrequent meals, it can help.
  • Hold your baby correctly: Properly holding your baby as he eats is important. Hold him close in and make sure he's latched on correctly while breastfeeding. If bottle feeding, always hold your baby as he eats. Make sure the bottle is at an upright position that allows milk to fill the nipple - i.e. you should not see a lot of bubbles near the nipple.
  • After meal activity: Your baby should not be sitting straight up or participating in extra vigorous play or activity right after a meal. Also, tummy time right after eating is a no no.
  • Do not change formula: This used to be a commonly thought cure for reflux in newborns, but Healthline states that very rarely is this a smart way to treat reflux and can often cause more harm than good. Only change your baby's formula if your pediatrician advises you to do so.

Lastly, if your baby has one of these signs: weight loss, inflamed esophagus, baby respiratory infections, wheezing, or chronic cough, it could be a sign of reflux that requires medical care and treatment, so see your pediatrician. You can tell that your baby has an inflamed esophagus because he may spit up blood or refuse to eat. An overly colicky baby is another sign.

For more information visit the American Academy of Family Physicians.


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Types and Causes of Reflux in Newborns